搜索结果：Maternal health, neonatology and perinatology

Maternal health literacy is associated with greater odds of positive pregnancy outcomes. There is an increasing proliferation of websites dedicated to maternal health education, but the scope and quality of their content varies widely. In this study, we analyzed the main topics covered on maternal health websites that offer content in the low-resource Kinyarwanda language (mainly spoken by 12 million Rwandans). We used web scraping to identify maternal health websites. We utilized a topic modeling, using the Non-Negative Matrix Factorization (NMF) algorithm, to identify the topics. We found five main topics: (1) pregnancy danger signs, (2) child care, (3) intimacy (sex), (4) nutrition, and (5) the importance of doctor consultations. However, the articles were short and did not cater to fathers, pregnant adolescents, or those experiencing gender-based violence (GBV) or mental health challenges. This is despite 12.5\% women of reproductive age in Rwanda being victims of GBV and one in five women in low- and middle-income countries experiencing mental illness during the perinatal period. We recommend three automated tools, a topic recommender tool, culturally relevant automated articl

Mobile health (mHealth) programs utilize automated voice messages to deliver health information, particularly targeting underserved communities, demonstrating the effectiveness of using mobile technology to disseminate crucial health information to these populations, improving health outcomes through increased awareness and behavioral change. India's Kilkari program delivers vital maternal health information via weekly voice calls to millions of mothers. However, the current random call scheduling often results in missed calls and reduced message delivery. This study presents a field trial of a collaborative bandit algorithm designed to optimize call timing by learning individual mothers' preferred call times. We deployed the algorithm with around $6500$ Kilkari participants as a pilot study, comparing its performance to the baseline random calling approach. Our results demonstrate a statistically significant improvement in call pick-up rates with the bandit algorithm, indicating its potential to enhance message delivery and impact millions of mothers across India. This research highlights the efficacy of personalized scheduling in mobile health interventions and underscores the po

This report presents a statistical analysis of the impact of key maternal characteristics, including age, smoking status, parity, height, weight, and gestation period, on newborn birth weight. A realworld dataset comprising 1,236 observations was utilized for this investigation. The methodology involved comprehensive data cleaning, exploratory data analysis (EDA), and a series of parametric statistical tests, specifically the One-Sample t-test, Two-Sample t-test, Chi-Square tests, and Analysis of Variance (ANOVA). All analyses were conducted within the SAS programming environment. The study's findings indicate a statistically significant negative impact of maternal smoking on birth weight, a finding consistent with broader public health literature. Gestation period emerged as the strongest positive predictor of birth weight within this dataset. While the analyses using broad categories of maternal age and parity did not reveal significant differences in mean birth weight, a review of existing literature suggests more intricate, potentially non-linear relationships and nuanced effects of these factors. Similarly, maternal pre-pregnancy weight, though showing a weak linear correlatio

The ability to provide trustworthy maternal health information using phone-based chatbots can have a significant impact, particularly in low-resource settings where users have low health literacy and limited access to care. However, deploying such systems is technically challenging: user queries are short, underspecified, and code-mixed across languages, answers require regional context-specific grounding, and partial or missing symptom context makes safe routing decisions difficult. We present a chatbot for maternal health in India developed through a partnership between academic researchers, a health tech company, a public health nonprofit, and a hospital. The system combines (1) stage-aware triage, routing high-risk queries to expert templates, (2) hybrid retrieval over curated maternal/newborn guidelines, and (3) evidence-conditioned generation from an LLM. Our core contribution is an evaluation workflow for high-stakes deployment under limited expert supervision. Targeting both component-level and end-to-end testing, we introduce: (i) a labeled triage benchmark (N=150) achieving 86.7% emergency recall, explicitly reporting the missed-emergency vs. over-escalation trade-off; (i

Harnessing the wide-spread availability of cell phones, many nonprofits have launched mobile health (mHealth) programs to deliver information via voice or text to beneficiaries in underserved communities, with maternal and infant health being a key area of such mHealth programs. Unfortunately, dwindling listenership is a major challenge, requiring targeted interventions using limited resources. This paper focuses on Kilkari, the world's largest mHealth program for maternal and child care - with over 3 million active subscribers at a time - launched by India's Ministry of Health and Family Welfare (MoHFW) and run by the non-profit ARRMAN. We present a system called CHAHAK that aims to reduce automated dropouts as well as boost engagement with the program through the strategic allocation of interventions to beneficiaries. Past work in a similar domain has focused on a much smaller scale mHealth program and used markovian restless multiarmed bandits to optimize a single limited intervention resource. However this paper demonstrates the challenges in adopting a markovian approach in Kilkari; therefore CHAHAK instead relies on non-markovian time-series restless bandits, and optimizes mu

Maternal and child health is a critical concern around the world. In many global health programs disseminating preventive care and health information, limited healthcare worker resources prevent continuous, personalised engagement with vulnerable beneficiaries. In such scenarios, it becomes crucial to optimally schedule limited live-service resources to maximise long-term engagement. To address this fundamental challenge, the multi-year SAHELI project (2020-2025), in collaboration with partner NGO ARMMAN, leverages AI to allocate scarce resources in a maternal and child health program in India. The SAHELI system solves this sequential resource allocation problem using a Restless Multi-Armed Bandit (RMAB) framework. A key methodological innovation is the transition from a traditional Two-Stage "predict-then-optimize" approach to Decision-Focused Learning (DFL), which directly aligns the framework's learning method with the ultimate goal of maximizing beneficiary engagement. Empirical evaluation through large-scale randomized controlled trials demonstrates that the DFL policy reduced cumulative engagement drops by 31% relative to the current standard of care, significantly outperform

The study investigated the impact of healthcare system efficiency on the delivery of maternal, newborn, and child services in Africa. Data Envelopment Analysis and Tobit regression were employed to assess the efficiency of 46 healthcare systems across the continent, utilizing the Variable Returns to Scale model with Input orientation to evaluate technical efficiency. The Tobit method was utilized to explore factors contributing to inefficiency, with inputs variables including hospital, physician, and paramedical staff, and outputs variables encompassing maternal, newborn, and child admissions, cesarean interventions, functional competency, and hospitalization days. Results revealed that only 26% of countries exhibited efficiency, highlighting a significant proportion of 74% with inefficiencies. Financial determinants such as current health expenditures, comprehensive coverage index, and current health expenditure per capita were found to have a negative impact on the efficiency of maternal-child services. These findings underscore a marginal deficiency in technical efficiency within Africa's healthcare systems, emphasizing the necessity for policymakers to reassess the roles of bot

Agent-based simulation is crucial for modeling complex human behavior, yet traditional approaches require extensive domain knowledge and large datasets. In data-scarce healthcare settings where historic and counterfactual data are limited, large language models (LLMs) offer a promising alternative by leveraging broad world knowledge. This study examines an LLM-driven simulation of a maternal mobile health program, predicting beneficiaries' listening behavior when they receive health information via automated messages (control) or live representatives (intervention). Since uncertainty quantification is critical for decision-making in health interventions, we propose an LLM epistemic uncertainty estimation method based on binary entropy across multiple samples. We enhance model robustness through ensemble approaches, improving F1 score and model calibration compared to individual models. Beyond direct evaluation, we take a decision-focused approach, demonstrating how LLM predictions inform intervention feasibility and trial implementation in data-limited settings. The proposed method extends to public health, disaster response, and other domains requiring rapid intervention assessmen

Mobile health (mHealth) programs face a critical challenge in optimizing the timing of automated health information calls to beneficiaries. This challenge has been formulated as a collaborative multi-armed bandit problem, requiring online learning of a low-rank reward matrix. Existing solutions often rely on heuristic combinations of offline matrix completion and exploration strategies. In this work, we propose a principled Bayesian approach using Thompson Sampling for this collaborative bandit problem. Our method leverages prior information through efficient Gibbs sampling for posterior inference over the low-rank matrix factors, enabling faster convergence. We demonstrate significant improvements over state-of-the-art baselines on a real-world dataset from the world's largest maternal mHealth program. Our approach achieves a $16\%$ reduction in the number of calls compared to existing methods and a $47$\% reduction compared to the deployed random policy. This efficiency gain translates to a potential increase in program capacity by $0.5-1.4$ million beneficiaries, granting them access to vital ante-natal and post-natal care information. Furthermore, we observe a $7\%$ and $29\%$

Monitoring maternal and fetal health during pregnancy is crucial for preventing adverse outcomes. While tests such as ultrasound scans offer high accuracy, they can be costly and inconvenient. Telehealth and more accessible body shape information provide pregnant women with a convenient way to monitor their health. This study explores the potential of 3D body scan data, captured during the 18-24 gestational weeks, to predict adverse pregnancy outcomes and estimate clinical parameters. We developed a novel algorithm with two parallel streams which are used for extract body shape features: one for supervised learning to extract sequential abdominal circumference information, and another for unsupervised learning to extract global shape descriptors, alongside a branch for demographic data. Our results indicate that 3D body shape can assist in predicting preterm labor, gestational diabetes mellitus (GDM), gestational hypertension (GH), and in estimating fetal weight. Compared to other machine learning models, our algorithm achieved the best performance, with prediction accuracies exceeding 88% and fetal weight estimation accuracy of 76.74% within a 10% error margin, outperforming conve

Public health practitioners often have the goal of monitoring patients and maximizing patients' time spent in "favorable" or healthy states while being constrained to using limited resources. Restless multi-armed bandits (RMAB) are an effective model to solve this problem as they are helpful to allocate limited resources among many agents under resource constraints, where patients behave differently depending on whether they are intervened on or not. However, RMABs assume the reward function is known. This is unrealistic in many public health settings because patients face unique challenges and it is impossible for a human to know who is most deserving of any intervention at such a large scale. To address this shortcoming, this paper is the first to present the use of inverse reinforcement learning (IRL) to learn desired rewards for RMABs, and we demonstrate improved outcomes in a maternal and child health telehealth program. First we allow public health experts to specify their goals at an aggregate or population level and propose an algorithm to design expert trajectories at scale based on those goals. Second, our algorithm WHIRL uses gradient updates to optimize the objective, a

Automated voice calls are an effective method of delivering maternal and child health information to mothers in underserved communities. One method to fight dwindling listenership is through an intervention in which health workers make live service calls. Previous work has shown that we can use AI to identify beneficiaries whose listenership gets the greatest boost from an intervention. It has also been demonstrated that listening to the automated voice calls consistently leads to improved health outcomes for the beneficiaries of the program. These two observations combined suggest the positive effect of AI-based intervention scheduling on behavioral and health outcomes. This study analyzes the relationship between the two. Specifically, we are interested in mothers' health knowledge in the post-natal period, measured through survey questions. We present evidence that improved listenership through AI-scheduled interventions leads to a better understanding of key health issues during pregnancy and infancy. This improved understanding has the potential to benefit the health outcomes of mothers and their babies.

Maternal sensitivity is a modifiable determinant of infant attachment security and a precursor to optimal child development. Contextual stressors undermine sensitivity, but research was yet to be synthesized. We aimed to identify i) types of stress associations analyzed in studies of maternal sensitivity and ii) the strength of effects of various stress factors. A systematic search identified all studies that used the Maternal Behavior Q-Sort (MBQS) to code sensitivity in dyadic observations and that reported a coefficient for MBQS associations with contextual stress. Identified stressors cohered around three spheres: sociodemography (maternal education, family income, composite SES, maternal age and cohabitation status); parenting stress (perceived maternal stress related to parenting); and mental health (specifically maternal internalizing symptoms). Seven meta-analyses (combined ns range 223-1239) of a subset of 30 effects from 20 articles, and a multi-level meta-analysis (N=1324) assessed aggregated correlations with sensitivity. Significant mean effects emerged in expected directions, whereby all stress indicators were negatively associated with sensitivity. Small effects were

Electronic textiles (E-textiles) offer great wearing comfort and unobtrusiveness, thus holding potential for next-generation health monitoring wearables. However, the practical implementation is hampered by challenges associated with poor signal quality, substantial motion artifacts, durability for long-term usage, and non-ideal user experience. Here, we report a cost-effective E-textile system that features 3D microfiber-based electrodes for greatly increasing the surface area. The soft and fluffy conductive microfibers disperse freely and securely adhere to the skin, achieving a low impedance at the electrode-skin interface even in the absence of gel. A superhydrophobic fluorinated self-assembled monolayer was deposited on the E-textile surface to render it waterproof while retaining the electrical conductivity. Equipped with a custom-designed motion-artifact canceling wireless data recording circuit, the E-textile system could be integrated into a variety of smart garments for exercise physiology and health monitoring applications. Real-time multimodal electrophysiological signal monitoring, including electrocardiogram (ECG) and electromyography (EMG), was successfully carried o

In recent years, LLM-based maternal health chatbots have been widely deployed in low-resource settings, but they often ignore real-world contexts where women may not own phones, have limited literacy, and share decision-making within families. Through the deployment of a WhatsApp-based maternal health chatbot with 48 pregnant women in Lahore, Pakistan, we examine barriers to use in populations where phones are shared, decision-making is collective, and literacy varies. We complement this with focus group discussions with obstetric clinicians. Our findings reveal how adoption is shaped by proxy consent and family mediation, intermittent phone access, silence around asking questions, infrastructural breakdowns, and contested authority. We frame barriers to non-use as culturally conditioned rather than individual choices, and introduce the Relational Chatbot Design Grammar (RCDG): four commitments that enable mediated decision-making, recognize silence as engagement, support episodic use, and treat fragility as baseline to reorient maternal health chatbots toward culturally grounded, collective care.

Maternal mortality in Sub-Saharan Africa remains critically high, accounting for 70% of global deaths despite representing only 17% of the world population. Current digital health interventions typically deploy artificial intelligence (AI), Internet of Things (IoT), and blockchain technologies in isolation, missing synergistic opportunities for transformative healthcare delivery. This paper presents IyaCare, a proof-of-concept integrated platform that combines predictive risk assessment, continuous vital sign monitoring, and secure health records management specifically designed for resource-constrained settings. We developed a web-based system with Next.js frontend, Firebase backend, Ethereum blockchain architecture, and XGBoost AI models trained on maternal health datasets. Our feasibility study demonstrates 85.2% accuracy in high-risk pregnancy prediction and validates blockchain data integrity, with key innovations including offline-first functionality and SMS-based communication for community health workers. While limitations include reliance on synthetic validation data and simulated healthcare environments, results confirm the technical feasibility and potential impact of co

The rapid advancement of Artificial Intelligence (AI) in healthcare presents a unique opportunity for advancements in obstetric care, particularly through the analysis of cardiotocography (CTG) for fetal monitoring. However, the effectiveness of such technologies depends upon the availability of large, high-quality datasets that are suitable for machine learning. This paper introduces the Oxford Maternity (OxMat) dataset, the world's largest curated dataset of CTGs, featuring raw time series CTG data and extensive clinical data for both mothers and babies, which is ideally placed for machine learning. The OxMat dataset addresses the critical gap in women's health data by providing over 177,211 unique CTG recordings from 51,036 pregnancies, carefully curated and reviewed since 1991. The dataset also comprises over 200 antepartum, intrapartum and postpartum clinical variables, ensuring near-complete data for crucial outcomes such as stillbirth and acidaemia. While this dataset also covers the intrapartum stage, around 94% of the constituent CTGS are antepartum. This allows for a unique focus on the underserved antepartum period, in which early detection of at-risk fetuses can signifi

Automated voice calls with health information are a proven method for disseminating maternal and child health information among beneficiaries and are deployed in several programs around the world. However, these programs often suffer from beneficiary dropoffs and poor engagement. In previous work, through real-world trials, we showed that an AI model, specifically a restless bandit model, could identify beneficiaries who would benefit most from live service call interventions, preventing dropoffs and boosting engagement. However, one key question has remained open so far: does such improved listenership via AI-targeted interventions translate into beneficiaries' improved knowledge and health behaviors? We present a first study that shows not only listenership improvements due to AI interventions, but also simultaneously links these improvements to health behavior changes. Specifically, we demonstrate that AI-scheduled interventions, which enhance listenership, lead to statistically significant improvements in beneficiaries' health behaviors such as taking iron or calcium supplements in the postnatal period, as well as understanding of critical health topics during pregnancy and inf

Global rates of mental health concerns are rising, and there is increasing realization that existing models of mental health care will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health related tasks. In this paper, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs' application to mental health and encourage the adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. It is especially critical to ensure that mental health LLMs are fine-tuned for mental health, enhance mental health equity, and adhere to ethical standards and that people, including those with lived experience with mental health concerns, are involved in all stages from development through